Advanced Risk Score Predicts Long-Term Survival After Mitral Valve Surgery
Advanced Risk Score Predicts Long-Term Survival After Mitral Valve Surgery
Source: 2025
Original research: The Annals of Thoracic Surgery
1. Background
• Mitral valve replacement (MVR) is recognized for its significant operative risks, leading many high-risk patients to be excluded from surgical management
• The STS Risk Calculator is widely used for short-term mortality prediction.
• This study assessed its value for long-term (5-year) survival prediction.
2. Study Design
• Single-center, high-volume institution (2010–2023).
• Nearly 1,500 patients screened; final cohort 855 patients.
• Median age: 64 years; 63% women; 82% white.
• Case urgency: 75.5% elective, 23% urgent, 1.4% emergent, 0.1% salvage.
• Excluded patients with concomitant AVR or CABG.
3. Risk Categories (STS PROM)
• Low-risk: <3%
• Intermediate-risk: 3–6%
• High-risk: >6%
• Mean PROM for cohort: 5.9%.
4. Key Findings
• 5-year survival rates:
• Low-risk: 90.8%
• Intermediate-risk: 75.5%
• High-risk: 56.4%
• High-risk patients had more comorbidities (HTN, diabetes, MI, HF).
• Independent predictors of worse long-term survival:
• Preoperative dialysis
• Hypertension
• Urgent/emergent status
5. Conclusions
• STS PROM is effective for long-term risk stratification in MVR patients.
• Provides refined criteria to identify candidates for surgery vs. alternative therapies (e.g., transcatheter approaches).
• Enhances patient selection and may guide shared decision-making.
